Cognitive function in pediatric-onset relapsing myelin oligodendrocyte glycoprotein antibody-associated disease
Tracy L Fabri1, Julia O'Mahony2, Giulia Fadda3
1Department of Psychology, York University, Canada.
Insights
Pediatric-onset relapsing myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) shows milder cognitive deficits than pediatric-onset multiple sclerosis (POMS). MOGAD patients had slower response times and reduced complex cognition compared to healthy controls.
Area of Science:
- Neuroimmunology
- Pediatric Neurology
- Cognitive Neuroscience
Background:
- Myelin oligodendrocyte glycoprotein antibodies are present in 30-50% of pediatric acquired demyelinating syndromes.
- Cognitive impacts of relapsing MOGAD in youth are not well understood.
- Adults show a 41% higher relapse risk than children in MOGAD.
Purpose of the Study:
- To compare cognitive performance in pediatric-onset relapsing MOGAD, pediatric-onset multiple sclerosis (POMS), and healthy controls.
- To identify specific cognitive domains affected by pediatric MOGAD.
- To differentiate cognitive profiles between MOGAD and POMS.
Main Methods:
- Administered the Penn Computerized Neurocognitive Battery (PCNB) to 12 relapsing MOGAD, 68 POMS, and 108 healthy control participants.
- Assessed accuracy in Executive Function, Episodic Memory, Complex Cognition, and Social Cognition.
- Analyzed overall response time and global performance using multiple linear regression, controlling for age and sex.
Main Results:
- Relapsing MOGAD patients showed reduced accuracy in Complex Cognition and slower overall response times versus controls.
- MOGAD participants performed better in Executive Function and overall battery scores compared to POMS.
- POMS group had significantly lower overall PCNB scores than controls, while MOGAD did not differ significantly.
Conclusions:
- Pediatric-onset relapsing MOGAD is associated with milder cognitive impairments than POMS.
- MOGAD patients exhibit slower processing speed and deficits in complex cognition.
- Cognitive deficits in MOGAD are less pervasive than in POMS, suggesting distinct neurological impacts.
Introduction:
Myelin oligodendrocyte glycoprotein antibodies are identified in approximately 30-50% of youth with pediatric-onset acquired demyelinating syndromes. Little is known about the cognitive sequelae of relapsing myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) with onset in childhood or adolescence.Overall, adults had 41% more risk than children to relapse over the whole disease course Overall, adults had 41% more risk than children to relapse over the whole disease course OBJECTIVE: To compare cognitive performance in participants with pediatric-onset relapsing MOGAD, pediatric-onset multiple sclerosis (POMS), and age-matched healthy controls.
Methods:
The Penn Computerized Neurocognitive Battery (PCNB) was administered to 12 individuals with relapsing MOGAD (age = 16.3 ± 4.8 years; 75% female; disease duration = 8.1 ± 2.7 years), 68 individuals with POMS (age = 18.3 ± 4.0 years; 72% female; disease duration = 3.8 ± 3.9 years), and 108 healthy controls (age = 17.0 ± 4.9 years; 68.5% female). Accuracy was assessed on four domains: Executive Function, Episodic Memory, Complex Cognition, Social Cognition; and overall response time (RT) and RT across three factors (i.e., Time Constrained, Open-Window, Memory). Global performance was determined by a composite score. Multiple linear regression was used to examine group differences on PCNB domain and factor z-scores, controlling for age and sex. We also covaried disease duration for relapsing MOGAD vs. POMS analyses.
Results:
Relative to healthy controls, relapsing MOGAD participants were less accurate on the Complex Cognition domain (B=-0.28, SE=0.11, p=.02), and had slower overall response time (B=-0.16, SE=0.07, p=.02). Relative to POMS, relapsing MOGAD participants were more accurate on the Executive Function domain (B = 0.70, SE=0.30, p=.02) and on the battery overall (B = 0.41, SE=0.18, p=.02). Relative to controls, overall PCNB score was significantly lower in the POMS group (B=-0.28, SE=0.06, p<.001) whereas the relapsing MOGAD participants did not differ from controls (p=.06) on the overall PCNB score.
Conclusions:
The relapsing MOGAD group demonstrated reduced reasoning skills and slower overall response time, relative to controls. A broad pattern of deficits was observed among POMS participants relative to controls. Overall, cognitive difficulties in the MOGAD group were milder relative to the POMS group.
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